Background:Different homeopathic approaches have been used as supportive care for coronavirus dis-ease 2019(COVID-19)cases,but none has been tested in a clinical trial.Objectives:To investigate the effectiveness and safety of the homeopathic medicine,Natrum muriaticum LM2,for mild cases of COVID-19.Design,setting,participants,and interventions:A randomized,double-blind,two-armed,parallel,single-center,placebo-controlled clinical trial was conducted from June 2020 to April 2021 in S?o-Carlos,Brazil.Participants aged＞18 years,with influenza-like symptoms and positive result from a real-time polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 were recruited and randomized(1:1)into two groups that received different treatments during a period of at-home-isolation.One group received the homeopathic medicine Natrum muriaticum,prepared with the second degree of the fifty-millesimal dynamization(LM2;Natrum muriaticum LM2),while the other group received a placebo.Outcome measures:The primary endpoint was time until recovery from COVID-19 influenza-like symp-toms.Secondary measures included a survival analysis of the number and severity of COVID-19 symp-toms(influenza-like symptoms plus anosmia and ageusia)from a symptom grading scale that was informed by the participant,hospital admissions,and adverse events.Kaplan-Meier curves were used to estimate time-to-event(survival)measures.Results:Data from 86 participants were analyzed(homeopathy,n=42;placebo,n=44).There was no difference in time to recovery between two groups among participants who were reporting influenza-like symptoms at the beginning of monitoring(homeopathy,n=41;placebo,n=41;P=0.56),nor in a sub-group that had at least 5 moderate to severe influenza-like symptoms at the beginning of monitor-ing(homeopathy,n=15;placebo,n=17;P=0.06).Secondary outcomes indicated that a 50％reduction in symptom score was achieved significantly earlier in the homeopathy group(homeopathy,n=24;pla-cebo,n=25;P=0.04),among the participants with a basal symptom score≥5.Moreover,values of restricted mean survival time indicated that patients receiving homeopathy might have improved 0.9 days faster during the first five days of follow-up(P=0.022).Hospitalization rates were 2.4％in the homeopathy group and 6.8％in the placebo group(P=0.62).Participants reported 3 adverse events in the homeopathy group and 6 in the placebo group.Conclusion:Results showed that Natrum muriaticum LM2 was safe to use for COVID-19,but there was no statistically significant difference in the primary endpoints of Natrum muriaticum LM2 and placebo for mild COVID-19 cases.Although some secondary measures do not support the null hypothesis,the wide confidence intervals suggest that further studies with larger sample sizes and more symptomatic participants are needed to test the effectiveness of homeopathic Natrum muriaticum LM2 for COVID-19.Trial registration:UMIN Clinical Trials Registry ID:JPRN-UMIN000040602.

Ubiratan Cardinalli Adler;Maristela Schiabel Adler;Ana Elisa Madureira Padula;Livia Mitchiguian Hotta;Amarilys de Toledo Cesar;José Nelson Martins Diniz;Helen de Freitas Santos;Edson Zangiacomi Martinez

Department of Medicine,Federal University of S?o Carlos,S?o Carlos 13565-905,Brazil;Homeopathy Solidarity Outpatient Extension Program,Mackenzie Presbyterian University,S?o Paulo 01302-907,Brazil;Municipal Center for Integrative and Complementary Practices in Health,Guarulhos 07023-051,Brazil;HN-Cristiano Institute,S?o Paulo 02013-001,Brazil;School Health Unit,Federal University of S?o Carlos,Sao Carlos 13565-905,Brazil;Federal Institute of Education,Science and Technology of S?o Paulo,Birigui 16201-407,Brazil;Department of Social Medicine,Ribeir?o Preto Medical School,University of Sao Paulo,Ribeirao Preto 14049-900,Brazil

结合医学学报（英文版）

[1]Ubiratan Cardinalli Adler;Maristela Schiabel Adler;Ana Elisa Madureira Padula;Livia Mitchiguian Hotta;Amarilys de Toledo Cesar;José Nelson Martins Diniz;Helen de Freitas Santos;Edson Zangiacomi Martinez-.Homeopathy for COVID-19 in primary care:A randomized,double-blind,placebo-controlled trial(COVID-Simile study))[J].结合医学学报（英文版）,2022(03):221-229

Homeopathy,Simile,homeopathic,Natrum,muriaticum,millesimal,dynamization,ageusia,homeopathy,cebo,UMIN,JPRN,UMIN000040602

primary,care,randomized,double,blind,placebo,controlled,trial,study,Background,Different,approaches,have,been,used,supportive,coronavirus,dis,ease,cases,but,none,has,tested,clinical,Objectives,To,investigate,effectiveness,safety,medicine,LM2,mild,Design,setting,participants,interventions,two,armed,parallel,single,center,was,conducted,from,June,April,Carlos,Brazil,Participants,aged,years,influenza,like,symptoms,positive,result,real,polymerase,chain,reaction,severe,acute,respiratory,syndrome,were,recruited,into,groups,that,received,different,treatments,during,period,isolation,One,prepared,degree,fifty,while,other,Outcome,measures,until,recovery,Secondary,included,survival,analysis,number,severity,plus,anosmia,grading,scale,informed,by,hospital,admissions,adverse,events,Kaplan,Meier,curves,estimate,Results,Data,analyzed,There,difference,between,among,who,reporting,beginning,monitoring,nor,sub,had,least,moderate,outcomes,indicated,reduction,score,achieved,significantly,earlier,basal,Moreover,values,restricted,mean,patients,receiving,might,improved,days,faster,first,five,follow,Hospitalization,rates,reported,Conclusion,showed,there,statistically,endpoints,Although,some,secondary,not,null,hypothesis,wide,confidence,intervals,suggest,further,studies,larger,sample,sizes,more,symptomatic,needed,registration,Clinical,Trials,Registry

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